HYPERTENSION AWARENESS, TREATMENT AND CONTROL AMONG MINORITY ETHNIC POPULATIONS IN EUROPE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Objective: Ethnic minority populations in Europe are disproportionally affected by hypertension-related complications. Early detection, adequate treatment and control of hypertension can help to prevent these complications. We conducted a systematic review and meta-analysis to quantify levels of hypertension awareness, treatment and control among minority ethnic populations residing in Europe compared to the host European population. Design and method: MEDLINE, EMBASE and Web of Science were systematically searched for population-based studies reporting levels of hypertension awareness, treatment or control in minority ethnic populations in Europe. Using Review Manager, pooled odds ratios (OR) with corresponding 95% confidence intervals (CI) were calculated, stratified by ethnic group. Results: 3532 records were screened of which sixteen were included in the analysis, comparing data of 26,800 subjects from five minority ethnic groups with 57,000 subjects from the European host population. African origin populations were more likely to be aware (OR 1.26, 95% CI 1.02–1.56) and treated (OR 1.49, 1.18–1.88) for hypertension, but less likely to have their blood pressure (BP) controlled (OR 0.56, 0.40–0.78), compared to the European host population. Compared to the host population, South Asian (SA) origin populations were more likely to be aware (OR 1.15, 1.02–1.30) of their hypertension status, but there were no differences in treatment and control rates. In Turkish and Moroccan origin populations, hypertension awareness rates were lower (Turkish OR 0.81, 0.65–1.00; Moroccan OR 0.46, 0.62–1.00), as were treatment levels in Moroccan population (OR 0.77, 0.60–0.97), and a trend towards lower BP control rates compared to the European populations. Hypertension awareness and control rates did not differ between Chinese origin populations and the European host population (no data on treatment available). Conclusions: Levels of hypertension awareness, treatment and control differ between ethnic groups in Europe. Effort should be made to improve hypertension control in African origin populations and awareness, treatment and control in Turkish and Moroccan populations, aiming to reduce ethnic inequalities in hypertension-related complications.